Module 3: Toxicology - Section 18: Reproductive Health Disorders in the Workplace

TOX 18.6 Reproductive Risk Assessment and Reproductive Risk Communication

5. REPRODUCTIVE RISK ASSESSMENT:

Employees have a legal and ethical right to know about hazards they face in the workplace and a reproductive risk assessment should help to provide information for this purpose. The steps generally conducted in a toxicological risk assessment may be adapted in simplified form for the clinical work-up, including:

1. Hazard identification of any hazardous agents the patient may be exposed to from a detailed occupational and environmental history.
2. Hazard evaluation to determine whether a given substance or physical agent may be a reproductive hazard by consulting databases and the literature.
3. Exposure assessment, which is performed by estimating the level of exposure from patient work history, product labels, material safety data sheets, industrial hygiene data, environmental sampling, or biological monitoring results, as well as potential routes of exposure and consistency of symptoms.
4. Risk characterization with respect to effects on the reproductive system. This activity is based on information gathered in the first three steps and considered: toxicity, timing and extent of exposure, potency, severity of outcome, and degree of uncertainty in animal and human studies.

6. REPRODUCTIVE RISK COMMUNICATION:

Building on the information gathered during the risk assessment process, risk communication is the logical follow-up. It is important to always consider that the threat or actual fact of adverse reproductive outcome has a profound impact on an individual’s life and must be dealt with sensitively. All questions must be answered truthfully and completely. A description of the lack of adequate knowledge and research data but the need for caution must be stressed. The timing of exposure and of the first contact with the risk communication should conducted prior to actual exposure in order to intervene at the primary prevention stage. The options available for the female worker should be presented in such a way that the medical impact as well as the economic consequences of decisions are understood and discussed. The occupational medical practitioner may need to communicate the risks to the employer as well, in order to resolve the situation. The medical confidentiality of the involved individual must however be maintained.

Postgraduate Diploma in Occupational Health (DOH) - Modules 3: Occupational Medicine & Toxicology (Basic) by Profs Mohamed Jeebhay and Rodney Ehrlich, Health Sciences UCT is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 2.5 South Africa License. Major contributors: Mohamed Jeebhay, Rodney Ehrlich, Jonny Myers, Leslie London, Sophie Kisting, Rajen Naidoo, Saloshni Naidoo. Source available from here. For any updates to the material, or more permissions beyond the scope of this license, please email healthoer@uct.ac.za or visit www.healthedu.uct.ac.za. Last updated Jan 2007.
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